8.K. Round table: Tracing evidence from policy to Impact: mapping the performance pathway

Abstract Background WHO and the European Observatory (OBS) have developed the global Health System Performance Assessment (HSPA) framework, aligning multiple existing approaches to assess health systems. While traditional HSPA exercises focus primarily on outcomes and rely on an analysis of several individual (quantitative) indicators on a dashboard as a final output, the distinct focus here is identifying root causes in health system bottlenecks. The WHO-OBS framework uses a “performance pathway” approach to link health system functions to system performance for policy-makers (1) to gain a clearer understanding of the relationships between health system inputs, processes, outputs and outcomes, and (2) to understand the influence of health system factors that determine performance. This approach enables policy-makers and technical agencies working on HSPA to: • identify areas of suboptimal performance in the health system and understand the root causes; • design appropriate policy actions aimed to address the root causes; • use the HSPA framework as a guide to test the impact of planned policy actions on health system goals and different parts of the system where there may be potential spill overs by working through the linkages within the system; • use a common approach that can help regularly identify what is not working in the aim of finding workable solutions. WHO and OBS are currently testing the concept of linking HSPA-relevant indicators (quantitative and qualitative) to policy questions and performance pathways in several countries. The aim is to identify best practices to not only regularly implement a national-level HSPA but make it indispensable for supporting evidence-informed practice with the regular analysis and dissemination of empirical data on countries’ policy priorities. This concept testing involves working with policy-makers who have a good view of country politics, mid-level technical civil servants who formulate policies and technical agency or ministerial staff managing performance monitoring data sets. Objectives This workshop will present the methodology of the performance pathway approach in the WHO-OBS framework followed by country-level examples and foster discussion around enabling environments for HSPA implementation and feedback to policy-makers. Specifically, it aims to: • present the WHO-OBS HSPA framework; • provide insights into recent/ongoing experiences of implementation via country case studies; • solicit active audience engagement on other country experiences to further the relevance of the framework and the performance pathway approach; • explore what's needed to strengthen country-level capability for regular HSPA implementation and adoption. Format A keynote will introduce the background and methods of the work. An interactive, OBS-moderated roundtable with panelists from case studies (Austria, Finland, Germany, Estonia) will delve into results and their implications. Audience input will be encouraged. Key messages • Performance pathways link actions and outcomes in a standardized way, highlighting cause-and-effect dynamics. • Sharing experiences and evidence is key to inform effective HSPA implementation. Speakers/Panellists Katharina Achstetter Technische Universität Berlin, Berlin, Germany Liina-Kaisa Tynkkynen THL, Tampere, Finland Pia Kreutzer Austrian Federal Ministry of Labour, Social Affairs, Health, Care and Consumer Protection, Vienna, Austria Marina Karanikolos European Observatory on Health Systems and Policies, London, UK